Endocrinologist tells Ideas Fest audience: Sugar is the root of all evil

True or false: A calorie is a calorie is a calorie, whether you get the calories from a brownie sundae or a handful of almonds.

If you think true, you’re following conventional wisdom and what the author of “Fat Chance: The Bitter Truth About Sugar” calls common sense.

Except Robert H. Lustig, a pediatric endocrinologist who spoke on Day 2 of the Aspen Ideas Festival, says he doesn’t believe in common sense. He believes in data.

And his data show a calorie eaten is not necessarily a calorie absorbed.

Speaking to an overflow crowd at Gisella Restaurant in downtown Aspen on Friday, Lustig said the hallmark of a diet that works is one that eschews all sugar and processed food, and instead focuses on fiber.

It’s called “real food,” he said.

Lustig practices in the field of neurobiology with an emphasis on the regulation of energy balance by the central nervous system, and has a special interest in childhood obesity. He made a name for himself after delivering a lecture in 2009 about the evils of sugar that went viral on the Internet. His theory that fructose is toxic, and its presence in our diets is a cause of rampant obesity is not without controversy, as his work has been disputed by some scientists in the obesity and nutrition research community.

No matter. He told the lunchtime crowd, who munched on finger sandwiches, salad and platters of cookies, he stands by his findings.

“It’s not a theory; it’s about the data,” he said. “It’s science-based.”

Take that handful of almonds. It has around 160 calories, but you absorb about 130 calories. Where does the extra 30 calories go? The fiber in the in the almonds prevented the absorption, so more energy gets “eaten up” by the bacteria in your intestine. The fiber makes a difference, Lustig said, for the good microbiome in your gut.

The foodstuffs we get fall into four categories, including the fiber. Another is protein, which takes twice as much energy to metabolize as carbohydrates, and affects our hunger hormones.

A third is fats. Omega 3s are good, but trans fats “are the devil incarnate,” Lustig said. They can’t grow on any of our microbiome, and our mitochondria can’t digest them.

And the fourth, fructose, he said “is completely vestigial, our need for them left over from when we deviated from plants. You don’t need the stuff. You do need glucose; your cells need it … but fructose is completely unnecessary.” People who eat a sugar-free diet “are the healthiest people on the planet,” he said.

Turns out, Lustig says, we have a limited capacity to metabolize sugar. “A little is OK, but a lot is not.” He said we should be taking our intake down from 22 teaspoons per day to just six.

It’s all in how quickly your liver gets overwhelmed trying to metabolize sugar. Fiber reduces the rate it gets into your liver portal, he said, but it still has no choice but to take that extra energy and convert it into fat.

Fructose is the biggest culprit, but trans fats and branch chain amino acids – that would be your corn-fed beef and fish – play a role in making you fat as well.

Lustig says anyone, including the non-obese, can get metabolic syndrome, a catch-all phrase that refers to a combination of medical disorders that when occurring together, increase the risk of diabetes and cardiovascular disease. Sugar, he said, is the “proximate cause of diabetes world wide. Twenty-five percent of all the diabetes in the world is caused by sugar, and sugar alone – it’s about sugar consumption.”

The food industry is slow to respond to the need to reduce sugar in processed food. “[The food industry] said ‘we can change, with two provisions: don’t do it alone, and we can’t lose money.’ That’s two non-starters,” he said.

He also said the industry is will react to the market.

“The fact is, the food industry has a business philosophy that’s reactive [to consumer demand] and proactive – if we build it they will come.” The latter, he said, is what caused the current problem because of the addiction problem.

In a nutshell, here is what Lustig has found that he shared with his Aspen Ideas Fest audience:

1. Eating wild-caught everything, including fish, is better for your health, and will prevent the inflammatory fatty acids that drive heart disease.

2. A low-sugar, high-fiber diet works because it’s “real food.”

3. Processed food, a suburban culture phenomenon, is “great for your wallet and time, but crappy for your health.”

4. Sugar is the single thing in your diet that you don’t need, and is a true addiction and satisfies the government’s definition: ubiquity, toxicity, addictive and has a negative impact on society. Salt, caffeine and fat don’t necessarily fall into the “addictive” category, he said.

5. Exercise is the “best single thing you can do to detox your body” from the liver overload that fructose delivers.

6. Protein powder is OK for body builders, but if you’re not a body builder and there is no place in the body to store the excess protein, it goes to your liver to store “and drives the same liver fat that fructose does.”

7. Alcohol doesn’t convert to sugar in the body, though most goes to your liver, which takes it down to the mitochondria, and if there is excess, it becomes liver fat (not a good thing).

8. Juicing is fine – if you juice vegetables and not fruits. The reason you should avoid the fruit smoothies, he said, is because your body needs both insoluble cellulose and soluble pectin to create the gel on the inside of your intestine. Juicing shears the insoluble fiber “to smithereens” and can’t reduce the rate of absorption. “Be careful with fruit,” he advises. Eat it whole.

9. The only “whole grain” you should be eating is the actual bran-coated grain that hasn’t been pummeled into a bread or other processed food. The FDA has no definition of “whole grain” which is actually in its raw form a slower of absorption. Anything else is probably bogus.